Posted by angier29 on November 18, 2010, at 19:53:00
I'll try to be succinct. My first problem (started 9 years ago) was insomnia and moderate-severe anxiety near sleep time. The first med I was prescribed was .5mg xanax before sleep. Worked well for a few months; doc then switched me to Remeron/Trazodone, I tolerated that change without a problem. Eventually a combination of Remeron/Effexor was agreed to and it got me through college (although effexor was useless and cutting every morning class for 4 years is what actually helped). After graduation I didn't work a lot, and my sleeping got worse. Doc was happy to add Ambien to the Remeron, in fact for a while he was allowing me 20mgs instead of the normal 10mgs. Ambien was awesome at first, now it's just something that I take 10-15mgs.
About 2 years ago, I started working part time at a community college. Working regularly, I wanted a safety net of anti-anxiety medications and my doc agreed to .5mg xanax bid. For the last year, I had a pretty good streak going. I was using about 30% of my rx'd xanax, 85% of my ambien and I was poised to land a nice full time gig at the college. Unfortunately, things didn't work out with the job and this triggered a bout of pretty severe anxiety/insomnia that I have not been able to get a handle on for the last 6 weeks.
I went to the doc and said I felt like I needed more xanax because I was having anxiety every waking hour and sleeping under 3 hours a night. His reaction was pretty extreme and negative. He said he hated Xanax, wants me back on effexor/zoloft whatever other SSRI that has NEVER helped my anxiety/insomnia, but that he's open to switching me over to klonopin.
So, these are my concerns. I know what to expect from xanax. I know that .5 calms me for 4-6 hours, 1mg gets the job done if I'm having moderate on the verge of servere anxiety, 1.5mg for emergencies and 2mg for defcon 1 anxiety (my current rx is 1mg a day, but i have about a 50 mg safety net). I fear that he will want to make a clean switch to the klon and underdose me with it. I also fear that the drug will be weaker and my anxiety will break through because I will no longer have a xanax backup option. However, I do think my main issue now is interdose/psychologically induced anxiety and klonopin sounds like a better option at the right dose. How do I approach this with my doc? He seems like a schizo about benzos; one month he's giving me 20mgs ambien, next he's having a fit about raising xanax to .5 tid. I really need to stabilize this situation because I obsess over every last detail of this thing.
Thanks for reading.
poster:angier29
thread:970705
URL: http://www.dr-bob.org/babble/20101117/msgs/970705.html